In dialogue with Estonia, Committee on the Rights of Persons with Disabilities expresses concerns about guardianship, COVID-19 response and situation of children with disabilities
The Committee on the Rights of Persons with Disabilities today concluded its review of the initial periodic report of Estonia on its implementation of the Convention on the Rights of Persons with Disabilities.
Committee Experts noted that people with restricted legal capacity had been disenfranchised: their political rights were restricted because of guardianship. Were there measures to uphold the full legal capacity of persons with disabilities, on an equal footing with others? How many persons with disabilities had lost their political rights due to guardianship, and who was usually chosen as the guardian? They asked Estonia to clarify the current state of supported decision-making provisions, and about progress in implementing them.
Committee Experts inquired about the inclusion of persons with disabilities in Estonia’s COVID-19 pandemic response, including how education was being handled for children with disabilities. They also asked whether Estonia included persons with disabilities in its vaccination programmes against the COVID-19 pandemic. What was their level of priority?
Rait Kuuse, Deputy Secretary General on Social Policy, Ministry of Social Affairs of Estonia, said Estonia was redesigning the support systems for children with special needs, and would bring together assessments and decisions in the social and educational fields so the parents did not have to turn to several institutions. Estonia still had work to do to meet the requirements of the Convention and the needs of persons with disabilities. The rights of persons with disabilities were among Estonia’s political priorities; it was hoped that future progress would be swift.
He added that supporting children with special needs and disabilities was one of Estonia’s priorities. The need and volume of social services were assessed by local governments, which also mapped the number of support specialists as well as children's needs, and created a reasonable system of providing support to children and their families. Teacher training developed competencies on how to properly include and support children with special educational needs and children with disabilities. Throughout the current school year and the COVID-19 pandemic, the main principle in education for children with special educational needs was to remain in contact learning form. Another principle had been to keep all vital services for children and other people with special needs open and available.
The delegation said that guardianship was only established in cases where the use of supported decision-making would not be possible. It was also established in as limited a way as possible. A person’s ability to vote was considered separately in every case by a court, with the assistance of an expert. Courts were each year establishing guardianships that were more limited in scope.
In his concluding remarks, Mr. Kuuse expressed appreciation for the questions of the Committee Members, and acknowledged the need for Estonia to strengthen the public debate on, and understanding of, the well-being of persons with disabilities, which needed to be prioritized.
Juta Saarevet, Representative of the Chancellor of Justice of Estonia, thanked the Committee for its important questions as well as the Estonian delegation for its answers, noting that many clarifications about the upcoming plans of the State had been given, which allowed her Office to be more optimistic about the future. The Office of the Chancellor of Justice would continue to fulfil its duties as the monitoring mechanism constructively and in good cooperation with persons with disabilities.
Jonas Ruskus, Committee Rapporteur for Estonia, commended the country for making efforts to advance the Convention, in partnership with organizations of persons with disabilities; for the progress achieved in accessibility; and for the reforms to promote employment of persons with disabilities. However, many elements of the medical model of disability still persisted in Estonia. Attitudinal barriers, including the terminology used throughout the dialogue, showed that persons with disabilities were still considered subjects of “special needs.” The rights of persons with disabilities to freedom, equality and social inclusion were not “special needs.” Persons with disabilities being deprived of their legal capacity perpetuated the medical model of disability, instead of implementing the human rights model of disability, as provided within the Convention.
Rosemary Kayess, Committee Chairperson, thanked the Estonian delegation on behalf of the Committee.
The delegation of Estonia was composed of representatives from the Ministry of Social Affairs, the Ministry of Education and Research, the Ministry of Economic Affairs and Communications, the Ministry of Justice, and the Permanent Mission of Estonia to the United Nations Office at Geneva.
All the documents relating to the Committee’s work, including reports submitted by States parties, can be found on the session’s webpage. The webcast of the Committee’s public meetings will be available via the following link: http://webtv.un.org/meetings-events/.
The Committee will next meet in public on 22 March at 12.30 p.m. to hold a general discussion in the context of its work on a General Comment on Article 27 of the Convention on the right to work and employment.
Report
The Committee has before it the initial periodic report of Estonia (CRPD/C/EST/1).
Presentation of the report
RAIT KUUSE, Deputy Secretary General on Social Policy, Ministry of Social Affairs of Estonia, said that his Government, its ministries, its numerous partners and the delegation found it very important to have a constructive dialogue with the Committee. Introducing aspects of Estonia’s report to the Committee, he said a new system had been set up in 2016 for supporting working ability, which was based on an individualized approach. It had had a positive effect on labour market participation of persons with disabilities. The employment rate of persons with disabilities had increased from 31.2 per cent in 2015 to 41.5 per cent in 2019.
Accessibility and universal design had become priorities for Estonia. A 2018 regulation provided detailed building requirements that were related to the special needs of persons with disabilities. An Accessibility Task Force had conducted a review of the accessibility of Estonian society, focusing on housing, public buildings, road infrastructure, public transportation, audiovisual media, and e-services. The Task Force’s preliminary policy proposals would be finalized and implemented in 2021. Since January, sign language interpretation was available via Estonia’s Social Insurance Board, and was provided to all age groups via Skype. Estonia’s technical aid system was reorganized in 2016. With later amendments, the reorganization had simplified the evaluation of people’s needs for technical aids.
Transition from institutional care, which prevailed in the past, to community-based care had been one of the Government’s priorities. During the last 10 years, the budget for special care services had doubled. Responsibility for assisting persons with disabilities was divided between the State and local governments, and regional disparities had led to an unequal availability and quality of assistance. Both State and local governments had acknowledged the need to simplify the journey of persons with disabilities in the assistance system. Estonia was redesigning the support systems for children with special needs, and would bring together assessments and decisions in the social and educational fields so the parents did not have to turn to several institutions.
Estonia still had work to do to meet the requirements of the Convention and the needs of persons with disabilities. Estonia faced challenges in the fields of equal treatment and non-discrimination, accessibility, social protection provided by local governments, and supervision. The rights of persons with disabilities were among Estonia’s political priorities; it was hoped that future progress would be swift.
JUTA SAAREVET, Representative of the Chancellor of Justice of Estonia, noted that since 2019, her Office was the independent monitoring institution of Estonia. During those two years, she had seen significant improvement in awareness of the rights of persons with disabilities among civil servants and service providers, but especially within Estonian society. As an example of the significant improvement of the situation of persons with disabilities, she noted that elections held in 2019 had not been accessible, and that, because of criticism by her Office, upcoming elections would be accessible to all people with reduced mobility, the deaf, the blind, and everyone else. However, challenges remained. The Equal Treatment Act was in conflict with the principles of the Constitution and the Convention. Despite the adoption of the Act, persons with disabilities were still deprived of equal access to services, including social welfare, healthcare, housing and education. Efforts and motivation were still insufficient when it came to making those services accessible to persons with disabilities. It was hoped that State authorities would mark that milestone soon, and that persons with disabilities would soon be able to exercise their rights on an equal basis with others.
Questions by Committee Experts
JONAS RUSKUS, Committee Rapporteur for Estonia, commended the Government of Estonia for its new Work Ability Support System, which had had a positive effect on the employment of persons with disabilities. However, the disability-assessment system was still not aligned with the human rights model of disability enshrined in the Convention. It was concerning that children with disabilities had lost their disability status by decisions of disability-assessment administration bodies, and thus lost support for their social inclusion. How had that issue been solved, and had recommendations of organizations of persons with disabilities been taken on board?
Group homes perpetuated institutionalization and the social segregation of persons with disabilities. Did the Government plan to redirect European Union Structural Funds from building new institutions to developing personal assistance arrangements, and make accessible regular services and facilities for persons with disabilities? He asked if the Government planned to repeal discriminatory legislation allowing for the deprivation of legal capacity of a person on grounds of impairment. The draft Additional Protocol to the Oviedo Convention on Human Rights and Biomedicine of the Council of Europe seriously conflicted with the Convention, as it legitimized the use of force and arbitrary deprivation of liberty, contained stigmatizing language referring to persons with psychosocial disabilities, and breached the right to non-discrimination. Did Estonia intend to oppose the adoption of the protocol?
An Expert was concerned that Estonia did not give enough financial support to organizations of persons with disabilities, and asked why that was the case. Another Expert asked about measures taken to involve women with disabilities in the development of gender equality- and disability-related legislation and policies. What mechanisms had been put in place for children with disabilities to express their opinions on matters which affected their lives?
ROSEMARY KAYESS, Committee Chairperson, asked for information about the current status of the draft proposal to amend the Equal Treatment Act, and whether the reforms addressed multiple and intersectional discrimination. Would the denial of reasonable accommodation be included in the definition of discrimination on the ground of disability?
Responses by the delegation
RAIT KUUSE, Deputy Secretary General on Social Policy, Ministry of Social Affairs of Estonia, said that, before reforms, people with special needs were placed in large, separately located institutions. Estonia had managed to reform the system and had only a few big facilities left where special care services were provided. Most people had moved to modern, smaller houses in cities where they could use public services and go to work if they were willing and able to. Regarding supported decision-making, Estonia was still debating how its current system could be improved to move toward such a practice. About support to organizations representing persons with disabilities, Estonia had made progress over the years, but more could be done. A long-term partnership with a funding framework was now in place, and local municipalities also supported local organizations.
Amendments to the Equal Treatment Act were truly necessary, said a member of Estonia’s delegation, adding that a draft proposal was being prepared, aiming to widen the scope of application of the Act concerning discrimination of persons on grounds of religion and other beliefs, age, disability and sexual orientation. Supporting children with special needs and disabilities was one of Estonia’s priorities. The need and volume of social services were assessed by local governments, which also mapped the number of support specialists as well as children's needs, and created a reasonable system of providing support to children and their families. Teacher training developed competencies on how to properly include and support children with special educational needs and children with disabilities.
Questions by Committee Experts
Committee Experts asked about COVID-19 pandemic recovery measures and how they included persons with disabilities. An Expert asked what was meant by “passive legal capacity” and “active legal capacity”. Were there plans to reduce the amount of time people might spend under guardianship? Deinstitutionalization didn’t mean moving people from large buildings to small buildings. What was Estonia doing to move away from small and medium-size group homes? Did the Government have any plans to amend the various procedural codes to provide persons with disabilities with alternative and augmented means of information and communication, such as Braille, sign language, Easy Read, audio and video transcription? These were means of universal design which were necessary for facilitating persons with disabilities’ effective role in all legal proceedings on an equal basis with others. How was Estonia preventing coercion and non-consensual institutionalization? Whichindependent monitoring mechanisms existed to prevent violence against persons with disabilities in all institutions?
Responses by the delegation
RAIT KUUSE, Deputy Secretary General on Social Policy, Ministry of Social Affairs of Estonia , said that all of Estonia’s strategies were subject to public consultation. Strategies must pay attention to the rights and needs of persons with disabilities. The Welfare Development Plan focused on the strategic objectives of labour markets, social protection, gender equality and equal treatment policies. The COVID-19 pandemic was far from over; it had hit Estonian society hard. Nevertheless, the country had kept open services for persons with disabilities. Rehabilitation services and schools had also been kept open most of the time.
The delegation added that, in Estonia, only a specified level of mental disability provided a basis to establish guardianship over a person. Guardianship was only established in cases where the use of supported decision-making mechanisms would not be possible; the extent of the guardianship should always be as narrow as possible. In order to determine the need for appointment of a guardian, the court ordered an expert assessment. Courts appointed guardians for adults with restricted active legal capacity by an order which had a validity of a maximum of five years. Estonia’s code of criminal procedure enabled persons with disabilities to participate in legal proceedings, including through sign language.
Throughout the current school year and the COVID-19 pandemic, the main principle in education for children with special educational needs was to remain in contact learning. Another principle had been to keep all vital services for children and other people with special needs open and available. To make sure that education remained accessible during the pandemic, the staff of special educational needs classes and schools were first among teachers to receive vaccinations. The vaccination of social-service providers had also started.
Estonia was committed to moving from institutional care to community-based care in the field of special care services. By 2023, Estonia planned to close 10 large, round-the-clock support special care homes and create additional community-based service centers. Eight large special care homes had already been closed. During the COVID-19 pandemic, home care was one of the services that was not suspended; emergency training had been provided for people who came to help. Estonia had encouraged service providers to find creative ways of providing services, such as operating outdoors. During the COVID-19 pandemic, shelters for women and children were all open, but only one was fully accessible for women and girls with disabilities.
In Estonia, everybody had access to health services according to their needs. Since the first days of the COVID-19 pandemic, persons with disabilities had been considered as a group with special communications needs. Mental health services had been designed to take those needs into account. Different ways of interacting with doctors and health facilities had been implemented, such as communication through video chats, phone calls and e-mail. Electronic channels of communication were designed according to standards on accessibility. Turning to questions about plans to abolish measures for confinement of persons with disabilities in the psychiatric system, a delegation member explained that psychiatric treatment, like all health services, required the informed consent of the patient. Means of restraint in facilities were used only in certain circumstances, as outlined in the Mental Health Act.
JUTA SAAREVET, Representative of the Chancellor of Justice of Estonia, said that Estonia in 2002 had joined the Convention Against Torture, as well as its Optional Protocol, which had entered into force in 2006. According to the Protocol, the Chancellor of Justice was the National Preventive Mechanism. Its task included regularly examining the treatment of persons deprived of their liberty in places of detention. Because of the COVID-19 pandemic, the National Preventive Mechanism’s inspection visits required extra precautions, such as the use of protective clothing and masks, but visits were continuing. Institutions monitored included establishments for children needing special treatment because of behavioural problems, special social welfare institutions, healthcare institutions providing psychiatric treatment, prisons, police departments, and more. Inspection visits could take place at any time, day or night; they could be announced or not. If ill-treatment that could be considered as criminal was observed, the public prosecutor’s office was notified.
Questions by the Committee Experts
JONAS RUSKUS, Committee Rapporteur for Estonia, noted that people with restricted legal capacity had been disenfranchised: their political rights were restricted because of guardianship. Were there measures to uphold the full legal capacity of persons with disabilities, on an equal footing with others? Were there discussions about reforming the Civil Code to bring it in line with the Convention? He also asked Estonia to clarify the current state of supported decision-making provisions, and about progress in implementing them. What protections were there against involuntary medical treatment and involuntary placement of a person with a disability? He asked what measures existed to ensure that persons with psychosocial disabilities were not deprived of their freedom on the grounds of their impairments. The Rapporteur also asked if Estonia envisaged reforms of the mental health legislation and practices to ensure human rights for all persons with disabilities. Were persons in mental health facilities considered in deinstitutionalization plans? Was informed consent ensured to all persons with disabilities with regards to any kind of medical treatment and intervention, including electro-convulsive therapy? Further details were requested on forced sterilization and forced contraception. The Rapporteur asked if these practices were prohibited and sanctioned, and whether there were mechanisms to identify instances of forced sterilization including in current institutions and small institutions. Could Estonia clarify which measures it had taken to provide personal assistance to persons with disabilities?
A Committee Expert expressed concern about persons with disabilities being brought to smaller homes, and asked if they chose which one to live in, and with whom. Were the rules in those homes the same as those in large institutions? Another Expert inquired about specific measures that existed to protect women with an intellectual disability during the COVID-19 pandemic.
Responses by the delegation
A member of the delegation said guardianship was only established in cases where the use of supported decision-making would not be possible. It was also established in as limited a way as possible. A person’s ability to vote was considered separately in every case by a court, with the assistance of an expert. Courts were each year establishing guardianships that were more limited in scope. A member of the delegation said that all treatments including mental health services were provided on the basis of free will and informed consent. There were criteria set up around involuntary emergency psychiatric care. A person could only be sterilized at his or her own request. Requests for sterilization must also be given in written form. Minors could not be sterilized.
Historically, in Estonia, people with mental disabilities had been gathered in a few large care homes across the country. With large institutions now being closed, the focus was on enabling people to return to their region of origin, or wherever they wished to go. Everyone could choose where and with whom to live. Every individual had their own room, but couples could live together. People were grouped in “families”, whose members had similar characteristics, such as diagnosis, age, or interests. Estonia was designing services as part of its work to create a person-centered and flexible special care service system so people could live in their own homes.
RAIT KUUSE, Deputy Secretary General on Social Policy, Ministry of Social Affairs of Estonia, noted that the Committee had highlighted the need to prioritize the needs of persons with disabilities when fighting the COVID-19 pandemic. He assured Committee Members that the needs of persons with disabilities were taken into account. Special emphasis was put on keeping necessary services available and delivering information in a format accessible to persons with disabilities.
A member of the delegation said all students in Estonia had a right to live at home, study with their peers at the local school, and receive a quality education. During the COVID-19 pandemic, the main principle in education for students with special educational needs and disabilities was to remain in contact learning for as long as possible. Regarding access to health care facilities during the COVID-19 pandemic, access had been limited for planned treatment and elective procedures. However, ambulance care and emergency rooms were open to all people, including persons with disabilities, if they needed immediate care or urgent medical checkups.
Questions by Committee Experts
Committee Experts asked about the modalities for deaf and blind children to access education. Regarding medical genetics, how were such methodologies being used, and were they consistent with State disability policies? Were genetics being used to prevent disabilities? Experts asked if there were any active parliamentarians in Estonia with disabilities. They also asked whether Estonia included persons with disabilities in its vaccination programmes against the COVID-19 pandemic. What was their level of priority? Which measures were in place for teaching Braille, and how many blind persons actually used the Braille system, Experts inquired. How many persons with disabilities had lost their political rights due to guardianship, and who was usually chosen as the guardian?
Responses by the delegation
RAIT KUUSE, Deputy Secretary General on Social Policy, Ministry of Social Affairs of Estonia, said that, as a small country, Estonia had an approach that was individualized: a tailored approach was used to provide aids and services to persons with disabilities.
A member of the delegation said that Estonia’s COVID-19 pandemic vaccine programme prioritized health system workers. Next came social care workers and their clients and people living in care homes. The third group was people over the age of 70, and people with special diseases or diagnoses, such as diabetes.
Closing remarks
RAIT KUUSE, Deputy Secretary General on Social Policy, Ministry of Social Affairs of Estonia, expressed appreciation for the questions of the Committee Members, and acknowledged the need for Estonia to strengthen the public debate on, and understanding of, the well-being of persons with disabilities, which needed to be prioritized.
JUTA SAAREVET, Representative of the Chancellor of Justice of Estonia, thanked the Committee for its important questions as well as the Estonian delegation for its answers, noting that many clarifications about the upcoming plans of the State had been given, which allowed her Office to be more optimistic about the future. The Office of the Chancellor of Justice would continue to fulfil its duties as the monitoring mechanism constructively and in good cooperation with persons with disabilities.
JONAS RUSKUS, Committee Rapporteur for Estonia, commended the country for making efforts to advance the Convention, in partnership with organizations of persons with disabilities; for the progress achieved in accessibility; and for the reforms to promote employment of persons with disabilities. However, many elements of the medical model of disability still persisted in Estonia. Attitudinal barriers, including the terminology used throughout the dialogue, showed that persons with disabilities were still considered subjects of “special needs.” The rights of persons with disabilities to freedom, equality and social inclusion were not “special needs.” Persons with disabilities being deprived of their legal capacity perpetuated the medical model of disability, instead of implementing the human rights model of disability, as provided within the Convention.
ROSEMARY KAYESS, Committee Chairperson, thanked the Estonian delegation on behalf of the Committee.
HRC21.002E